The OccuNet Company · 3 months ago
FairosRx Clinical Pharmacist (Full-Time)
United States
Full-time
Remote
Entry Level
1+ years expThe OccuNet Company is an innovative organization focused on reducing healthcare costs and improving access to affordable healthcare. As a FairosRx Clinical Pharmacist, you will provide clinical guidance, support member advocates, and review prior authorization requests to enhance client and patient services.
Health CareInsurance
Responsibilities
Review of prior authorization requests in accordance with member benefits and coverage criteria within defined turn-around times
Review prior authorizations and determine opportunities for interventions
Coordinate appeals
Provide clinical guidance and support to member advocates and account executives
Work with prescriber to provide other clinically equivalent but cost-effective alternatives
Receive/make phone calls from/to providers or members for clinical information and consulting
Analyze data to identify drug utilization trends and cost-savings opportunities
Generate and analyze prior authorization reports as well as other drug related reports
Continuously work to streamline and improve the quality of the prior authorization and drug utilization management processes
Motivates and works with clinical staff to ensure that performance standards are met or exceeded
Ensures clinical staff are appropriately educated on new programs, procedures, etc
Assist with other duties and special projects as assigned
Uphold compliance standards relating to HIPAA and Department of Labor guidelines when corresponding with providers and maintaining documentation
Maintain confidentiality of sensitive information
Qualification
Required
S. in Pharmacy or Doctor of Pharmacy (Pharm.D) degree required
Active, current and unrestricted pharmacist license/registration required; State of Texas preferred
One year of direct prior authorization experience required
Working knowledge of MediSpan data system, including GPI drug classification required
Excellent communication and interpersonal skills, written and verbal, with the ability to adapt appropriately for different audiences
Able to multi-task effectively and transition between tasks frequently
Able to maintain focus when presented with interruptions
Proactive problem-solving skills
Proficient computer skills, including Microsoft Office Suite
Team-first mindset with a high level of motivation and drive
Persistent with a drive to see tasks through when objectives are not met on the first try
Passionate and proactive about contributing to organizational missions focused on improving member experiences
Ability to remain calm and work efficiently in a fast-paced environment
Prolonged periods sitting or standing at a desk and working on a computer
Full-time, Monday to Friday 8 am – 5 pm CST
On-site, in-person working location in Amarillo, TX
Benefits
401(k) with matching
Dental insurance
Health insurance
Vision insurance
Health savings account
Paid time off
Company
The OccuNet Company
The OccuNet Company is an innovative healthcare cost containment company that offers out-of-network solutions (OccuNet), reference-based pricing (Fairos), and pharmacy benefits management (FairosRx).
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Scott Arlotta
Senior Vice President of Strategy and Business Development
Company data provided by crunchbase